Sunday, July 19, 2009

We just spoke with a nephrologist fellow and have some more news. Summary: Loki's kidney is probably blocked at the same place (the ureteropelvic junction, or UPJ) as in January, although the severity of this problem remains unclear. And he is still not eating enough, and runs a risk of dehydration, although it remains unclear if this is related to the kidney. Either way, a surgery is pretty likely.

Details: Loki is eating a bit more, like 20 mL every 2 hours. This is still about one-third of what he needs. Everything points to esophagus irritation from reflux as the cause. His reflux medications were increased a few days ago, and these can take several weeks to take effect. Thus, unless he becomes dehydrated, we should just wait.

Several things may point to kidney failure. Loki's urine output is low, and it is dark. His kidney is moderately enlarged. His ureter is not enlarged, implying that any blockage is at the UPJ. His creatanine (a protein that the kidney should be removing from the blood) is slightly elevated, although this could be caused (at least partially) by the kidney blockage. His potassium (which should also be cleaned from the blood by the kidney) was high. However, his 1:00 AM blood sample was a bit clotted (dried), which would have falsely increased potassium. Loki has his blood drawn about two hours ago.

Thus, we are facing two problems, none of which require action immediately as of yet. The irritated esophagus should improve on its own with the medication kicking in. The kidney probably won't improve on its own. Instead, it will likely need a surgery or two.

I'll sleep in the hospital tonight, and Mom may get her first full night's sleep in nine months at a nearby friend/nurse's house.

We do cross our fingers all day. What to do with this constantly coming up reflux? And again a surgery on this little man. He is in good hands but I can imagine you are both with mixed feelings. Hold on!! Big hug, marieke en martin XX

About Loki Sky

Loki Sky is a special little man. He was a very early micropreemie, weighing only 610 grams (1 lb, 5 oz) after 24 weeks, 3 days gestation, born to an American Father and a Dutch Mother in Berkeley, California on October 18, 2008.

On January 11, 2009, while still in the hospital NICU, his one kidney stopped working. It was repaired after three surgeries. After spending time in three hospitals in three cities, Loki came home on February 17. He struggled with eating, and then stopped in July, leading to 8 days in the hospital, a failure-to-thrive diagnosis, and a NG feeding tube. On October 10, a minor surgery installed a G feeding tube. Another procedure replaced it with a new one, and then again with a Mic-Key button in Jan. 2010.